Active Range of Motion verses Passive Range of Motion
The difference between Active Range of Motion testing and passive Range of Motion is primarily the difference between the patient assisting you and being fully relaxed. Active Range of Motion is when you are constantly checking in with the patient and you are asking the patient to move a limb in some sort of direction so that you can assess what range that they have usually done with a non-dysfunctional limb first to see what type of range that you could expect from the dysfunctional limb. Several different types of issues can be assessed when simply observing the patient they are their available range of motion, muscle strength, pain and coordination. In addition, the therapist can evaluate whether the motion is performed by concentric and eccentric muscle activity in order to determine which muscles are seeing dysfunctional movements. The therapist can instruct the patient how to make the movement and in some cases will need to demonstrate the movement. The therapist would then make note of the movement and if pain was involved in the movement.
Passive Range of motion testing is when the therapist has asked the patient to make the limb under test limp and not to assist the therapist in the motion being performed. Passive range of motion focuses on inert tissues because contractile tissues that are not used during passive motion are primarily those that you are testing. As a therapist moves the dysfunctional limb through the plain of motion attention should be made to the tissues to check for binding, restriction, and crepitus in the movement. The therapist should note levels of pain involved, checking for end feel which varies from patient to patient.
Manual resistive tests or isometric muscle contractions are so the therapist can correctly evaluate proper function of the contractile tissues during movement. Manual resistive tests are conducted to confirm and elaborate on findings from Active Range of Motion and Passive Range of Motion tests. During these test there should be no active movement at the joint. To conduct a manual resistive test you first need to determine the movement of the joint is it hinges, ball and socket, saddle. Then the therapist should select the plain of motion that they wish to test. The patient should be told to move the joint in that plain there may be too much pain for the patient to move the joint. This test may still be necessary to determine the issue that should be worked on.
The different type of tests are used to determine was muscle is dysfunctional and how to treat the muscle tissue. Passive tests allow the therapist to determine if soft tissue is not allowing for proper function of movement at a joint within a plane of motion. Active Range of motion testing allow us to assess if there is dysfunction in the movement and determine which muscles are used to make that movement happen. Muscle resistive tests allow us to determine what muscle tissue is dysfunctional while the movement is offering. This allows the therapist insight into the muscle contractile tissue and determines dysfunction that would not show up on active or passive range of motion tests.
The order that the test should be performed Active Range of motion is done first, which allows the therapist to watch and determine what movements that the patient can do on their own. Passive Range of Motion tests are then performed to allow for testing of muscle tissues that would hinder the range of motion. Then finally Muscle Reactive Tests are used to if something is wrong with the muscle tendon connections of the inert tissue so that proper treatment can be applied to the patient.
The differences in the tests and pain involved. Pain with active range of motion and no pain with passive range of motion can indicate that contractile tissues are dysfunctional. No pain with passive range of motion and no pain with active range of motion, but having pain with MRT tests would indicate that during active motion and passive motion that not enough muscle fibers are firing to indicate that pain would occur. Leaving musculotendinous junction would be injured and needed attention in the form of RICE.
